An Outbreak of H5N1: Mae Fah Luang University

Tawatchai Apidechkul,M.Sc. Dr.P.H. (Epidemiology)School of Health Science, Mae Fah Luang University, Thailand

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Epidemiology• Federal District of Mexico, surveillance began picking

up cases of Influenza-Like Illness (ILI) starting 18 March 2009.

• 23 April 2009, 854 cases of pneumonia, 59 had died.• 24 April 2009, The United States Government had

reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas).

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• Of the Mexican cases, 18 had been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those were genetically identical to the Swine Influenza A/H1N1 viruses from California.

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• The Swine Influenza A/H1N1 viruses characterized in this outbreak had not been previously detected in pigs or human.

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An Outbreak at MFU

• Early morning of 2 July 2009, the epidemiologist (Dr.Tawatchai Apidechkul) was called from the president of MFU to investigate and control the disease.

• About 100 cases were reported as respiratory tract infection.

• Severe cases were referred to Chiang Rai Center Hospital, to identify H1N.

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• On 3 July 2009, 3 positive H1N1 PCR results were reported

• Immediate actions were taken to investigate and control this outbreak.

• On 4 July 2009, we began to investigate the outbreak by closely monitoring patients and seeking suspected cases on the University campus where 1,115 students occupied in 32 dormitories.

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• Epidemiologist developed questionnaires based on MOPH ones to collect demographical and epidemiological data.

• Following control measures were implemented.• Patients were treated with proper care (intensive

care/isolated rooms). • Tamiflu and influenza vaccine were stockpiled.

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• Face masks were distributed. • Housekeepers and students were provided

with AVANTA® to disinfect areas of disease contamination in buildings and dormitories.

• Knowledge on influenza and personal hygiene were emphasized.

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• Large social gatherings were canceled. • Necessary activities were conducted in well-

ventilated areas.• Air conditioners were not operated. • Patients and suspected cases were asked to

wear face masks at all times and rest at dormitories; they were closely monitored after returning to classes.

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• During 2-7 July 2009, 165 patients (16, 33, 36, 54, 24 and 2 cases on consecutive days) were reported with signs and symptoms related to a novel influenza A (H1N1).

• Major signs included cough (83.9%), fever (70.3%), muscle pain (28.9%) and diarrhea (4.2%).

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• Mean age was 19.6 years (range 16-46 years); 68.5% were females; 58.1% and 22.9% were the 1st and 2nd year students, respectively.

• Most patients were students in Law School (16.25%) and Liberal Arts School (12.50%).

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• Six severe cases were admitted at Chiang Rai Regional Hospital, PCR positive with H1N1, and administered with Tamiflu. Attack rate was 89.7/1000 population.

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• Influenza A (H1N1) were rapidly transmitted in air conditioned classrooms.

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End Presentation!!But Disease Still Continue

Epidemic!!!